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Government pledges more midwives and support staff to bring better continuity of care

An extra 3,000 midwives will be trained over the next four years and a voluntary register set up for support staff, under a range of maternity care measures trailed over the weekend by the government.

The boost in numbers will start with 650 more midwives in training next year in England, representing a 25% rise, according to the Department of Health and Social Care (DHSC).

“The next step in my mission to transform safety standards is a drive to give mums dedicated midwives”

Jeremy Hunt

This will be followed by planned increases of 1,000 in the subsequent years as capacity rises, which will form part of the “largest ever increase in NHS midwives and maternity support staff”.

Nursing Times has asked the DHSC to clarify whether the increase will be achieved through an increase in funding for training placements for student midwives, in the same way that it was the mechanism behind pledges in the autumn on boosting the number of nurses being trained.

This is because, since it ended the provision of student bursaries and moved to loans, neither itself nor its arms’-length bodies directly commission course places at universities.

Meanwhile, the government also stated that there would be a new “defined maternity support worker role”, to increase professionalism, and new “training routes into midwifery” introduced.

“This profound change will be backed up by the largest ever investment in midwifery training”

Jeremy Hunt

These latter two moves regarding support workers hint at a similar approach to that already being adopted with nursing associates and nurse apprenticeships.

The DHSC highlighted that maternity support staff had “hugely important” roles in helping women and babies, but said their tasks and titles currently “vary widely and do not adhere to set standards”.

As a result, it said a defined role and national competency framework would be developed and a voluntary register established to provide assurance they were “appropriately trained to high standards”.

The department added that it would be working with “key partners”, such as the Royal College of Midwives, to develop new training routes into midwifery.

This would “mean talented support workers can develop and move quickly to become registered midwives and help the midwifery profession attract and retain talented staff”, it said.

Jeremy hunt new website

Jeremy Hunt

Accompanying the workforce rise plans, the DHSC has set a new ambition that the “majority” of women will receive care from the same midwives throughout their pregnancy, labour and birth by 2021.

Steps towards achieving this ambition will start with 20% of women benefitting from a “continuity of carer” model by March next year, said the department.

It noted that research suggested that women who used this model were 19% less likely to miscarry, 16% less likely to lose their baby and 24% less likely to have a premature baby.

Taken together, it said the plans would support the health and social care secretary’s drive to make the NHS the safest place to give birth and an existing ambition to halve rates of stillbirth, neonatal death and brain injury by 2025.

The measures were outlined over weekend, ahead of a speech by Jeremy Hunt at an event on Tuesday to mark two years since the launch of the Maternity Transformation Programme.

Mr Hunt said: “The next step in my mission to transform safety standards is a drive to give mums dedicated midwives, who can get to know them personally and oversee their whole journey from pregnancy to labour to new parent.

“The statistics are clear that having a dedicated team of midwives who know you and understand your story can transform results for mothers and babies – reducing stillbirths, miscarriages and neonatal deaths, and the agony that comes with these tragedies,” he said.

He added: “This profound change will be backed up by the largest ever investment in midwifery training, with a 25% expansion in the number of training places, as well as an incredibly well deserved pay rise for current midwives.”

The latter comment refers to the announcement last Wednesday that midwives, along with other Agenda for Change staff, were being offered a pay rise of at least 6.5% spread across three years.

The deal also includes a boost to the starting salary to make midwifery a more attractive profession. A newly qualified band 5 midwife will start on a salary of £24,907 by 2020-21 – a 12.6% rise on now.

Gill Walton, chief executive and general secretary of the RCM, said: “This is very long overdue acknowledgement by the government that England’s maternity services need more midwives.

“This announcement must be welcomed,” she said. “It will come as some relief to NHS midwives who have been working incredibly hard, for many years, with increasing demands and inadequate resources.”

“Simply training more midwives is only half of the problem”

Gill Walton

Ms Walton also said the commitment to more continuity of care was “good news” but cautioned that the associated target was “ambitious”.

“The additional midwives who start training next year won’t be qualified midwives working in our maternity services until 2022,” she noted.

“It will not transform maternity services right now,” she said. “It will take seven or eight years before all of the new midwives announced today will be actually working in our maternity services.”

She also called for more details on the number of extra support workers promised, though she said recognition of their importance and a commitment to invest in their training was “very good news”.

New chief executive takes over at midwives’ union

Gill Walton

But she added: “Until these midwives and maternity support workers are actually working maternity services will continue struggling to provide existing care where the focus is rightly safety first.

“Simply training more midwives is only half of the problem,” she said. “The other key issue is ensuring that when these midwives qualify they actually get jobs in the NHS.

“We must get a commitment from the government and trusts to employ them,” she said. “Trusts are going to need an increase in the money they get so they can employ the new midwives.”

Alison Edwards, senior lecturer in midwifery at Birmingham City University, said: “It isn’t as simple as recruiting thousands more students as this requires the infrastructure to support it.

”You need more tutors, more on site resources and perhaps more importantly, more mentors and capacity in placement areas – which currently is under immense strain,” she said ”Not only that, currently numbers of applicants are being put off by lack of funding and we have seen a drop in applicants ever since.

“Regarding having a named midwife. This has been on the cards in every maternity report since 1993 when the Changing Childbirth report came out from Baroness Cumberlege,” she added.

“Whilst small pockets of midwives do run this form of Midwifery to expect every midwife to be on call 24/7 for nine months is not really practical or feasible,” she said. “It is a lovely way to provide care but is it realistic or achievable?”

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